Provider Demographics
NPI:1235763053
Name:COUNTY OF LA CROSSE
Entity Type:Organization
Organization Name:COUNTY OF LA CROSSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR LONG TERM CARE &
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLACHECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-612-0640
Mailing Address - Street 1:962 GARLAND ST E
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:54669
Mailing Address - Country:US
Mailing Address - Phone:608-786-1400
Mailing Address - Fax:608-793-6505
Practice Address - Street 1:848 GARLAND ST E
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669
Practice Address - Country:US
Practice Address - Phone:608-612-0441
Practice Address - Fax:608-793-6695
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LA CROSSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility